title: Elevated sleep disturbance among blacks in an urban family medicine practice.
abstract: OBJECTIVE
  Blacks experience a number of health disparities. Sleep disturbances contribute to poor health. This preliminary study explores whether a disparity in sleep disturbances exists among blacks compared with whites and others.
  
  
  METHODS
  A cross-sectional study was conducted in a sample (n = 92) of urban primary care patients (52% black, 46% white, and 2% other) from a university-based family medicine practice. Mean (SD) age was 51.9 years (8.9 years). Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised, and a checklist of chronic health conditions.
  
  
  RESULTS
  The rate of clinically meaningful sleep disturbance was 71%. In bivariate logistic regressions, black race was associated with sleep disturbance (odds ratio [OR], 3.00; 95% CI, 1.17-7.69). Controlling for income attenuated that association by about 11% (race OR, 2.71; 95% CI, 1.04-7.06). Education explained about 35% (race OR, 2.39; 95% CI, 0.89-6.42). Adjustment for depression, chronic illness, and education simultaneously resulted in an estimate for race of OR, 2.44; 95% CI, 0.85-7.01.
  
  
  CONCLUSIONS
  Being black is associated with a sleep disturbance that is accounted for only partially by depression, socioeconomic status, and disease burden. Black primary care patients may benefit from additional screening and monitoring of sleep difficulties.
authors.affiliation: Department of Psychiatry, Sleep & Neurophysiology Research Laboratory, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Wilfred R
authors.initials: WR
authors.lastname: Pigeon
authors.forename: Kathi
authors.initials: K
authors.lastname: Heffner
authors.forename: Paul
authors.initials: P
authors.lastname: Duberstein
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Jan
authors.initials: J
authors.lastname: Moynihan
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Chapman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011320:Primary Health Care; D012893:Sleep Wake Disorders / Q000208:ethnology*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D001741:Black or African American